RESUMO
BACKGROUND: Patients with decompensated chronic heart failure (CHF) are frequently evaluated in emergency departments (ED). The outcomes of such patients after discharge to the outpatient setting from the ED are not well known. Risk factors for return ED visits or subsequent hospital admission after ED discharge for CHF also are not known. METHODS: Charts were reviewed from all 112 patients discharged from the Parkland Memorial Hospital ED with a primary diagnosis of CHF from October to December 1998. A composite end point ("failure of outpatient therapy") was prespecified to be a recurrent ED visit for CHF, hospitalization for CHF, or death at 3 months after the index ED discharge. RESULTS: Within 3 months of the index ED visit, 61% of the study population met the composite end point. The median time to failure of outpatient therapy was 30 days. Univariate analysis of 27 clinical and demographic variables demonstrated the respiratory rate at presentation as the only predictor of failure of outpatient therapy (P =.02). Multivariate analysis of a model with 8 prespecified variables also demonstrated respiratory rate to be the only variable independently associated with an increased risk for the composite end point (odds ratio 1.6, 95% confidence interval 1.1-2.6, for each increase of 5 breaths/min). CONCLUSION: There is a high rate of failure of outpatient therapy (61%) in patients discharged with a primary diagnosis of CHF from an urban county hospital ED. Increased respiratory rate on presentation to the ED may be associated with adverse outcomes after ED discharge for CHF.
Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Insuficiência Cardíaca/diagnóstico , Alta do Paciente/estatística & dados numéricos , Assistência Ambulatorial , Insuficiência Cardíaca/terapia , Hospitalização , Humanos , Readmissão do Paciente , Respiração , Falha de Tratamento , Resultado do TratamentoRESUMO
Impaired corpus callosum function has been reported in schizophrenia. We measured intra- and interhemispheric visual information processing in 16 schizophrenic patients and 16 matched controls. Although the schizophrenics performed worse between than within cerebral hemispheres, this pattern was similar to that of the normal controls. Schizophrenics do not show particular dysfunction of the corpus callosum.
Assuntos
Corpo Caloso/fisiopatologia , Esquizofrenia/fisiopatologia , Comportamento Verbal/fisiologia , Percepção Visual/fisiologia , Adulto , Córtex Cerebral/fisiopatologia , Feminino , Humanos , Masculino , Tempo de Reação/fisiologia , Leitura , Fatores SexuaisRESUMO
An apparatus which employs standard behavioral programming equipment is described. It enables the experimenter to program in advance with variables as auditory and visual instructional cues, delay intervals, and response mode, and to monitor response latency automatically. The apparatus is easily constructed, easily operated, and markedly increases the control of variables in tactile form perception experiments.
